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Starting the journey

Consult with your primary health care provider before beginning any weight loss treatment. You usually don’t need a referral to meet with a weight loss clinic, and initial consultations are free. However, it’s always a good idea to check with your primary doctor for recommendations and begin the process of sharing information between offices.

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Also, check with your insurance plans about what they will and won’t pay for. Many companies will pay for bariatric surgery if you meet certain requirements.

However, insurance companies generally don’t pay for nutrition counseling or classes. Individual plans vary greatly, and it’s up to you to know what your plan covers and what you can afford.

Nonsurgical options

• Diet and exercise: Depending on your health, this is the most common and least extreme weight loss solution. It also has the highest failure rate. Depending on your health, exercise plans should be entered into slowly and cautiously. You don’t want to push your body too far, causing injury, or worse, a heart attack, which will really complicate your weight loss efforts.

• Support groups and classes: Many hospitals and clinics offer healthy living classes and support groups. The gatherings teach cooking methods, exercise routines and other techniques to lose weight and stay fit.

• Meal replacement: Some hospitals and clinics offer programs that jump-start weight loss by replacing meals with shakes, protein packs, soups and other items. The meal replacements aren’t a permanent fix. Patients transition back to regular food after several weeks and begin lifelong healthy eating and exercise habits.

• Individual counseling: All local hospitals have nutritionists and dietitians who can help you plan your meals. Regular visits help in setting goals, understanding your individual health measurements and notching progress as you lose weight or searching for strategies to improve if you gain or become stymied.

Weight Loss Surgery

Patients undergo thorough counseling that includes meeting with a mental health counselor and beginning an exercise routine. A series of dietary restrictions is put in place to prepare the body for surgery. This takes place over the course of about six weeks.

Common types of bariatric surgery:

• Gastric bypass: The surgeon makes a small incision in the top of your stomach. The small intestine is divided and rearranged, creating a new, smaller stomach. The remainder of the stomach is not removed. This once-groundbreaking surgery is less common today.

• Gastric banding: The surgeon places a band — similar to a wristwatch — around the top of the stomach. The tightness of the band is adjustable. The surgery is reversible.

• Gastric sleeve surgery: The surgeon removes up to 80 percent of your stomach. This surgery narrows the stomach and reduces the amount of hormones produced by the stomach that cause hunger.

The pros of surgery: If you follow your doctor’s guidance, you will lose a lot of weight quickly. Gastric sleeve surgery patients have lost as much as 60 percent of excess body weight after a year. So a person who weighed 500 pounds at surgery would be down to 300 in a year.

The cons of surgery: With the exception of banding, it is irreversible. Failure to stick to dietary restrictions will result in vomiting. Some patients who have had gastric bypass have overeaten enough that their smaller stomach expanded.

Sources: U.S. Department of Health

Are you obese?

Your Body Mass Index is calculated based on your weight and height and is a fairly reliable indicator of body fat for most people. It’s one of the best methods for assessing whether you are overweight or obese, according to the U.S. Centers for Disease Control and Prevention.